The idea of prescribing HRT for women solely to keep them receptive to their partners’ advances is outrageous, as Germaine Greer has argued. Unfortunately this seems to have happened in the 1970s. ‘Because they desire the preservation of cosmetic youth and the unflagging libido of patients, physicians have championed estrogen [oestrogen] replacement therapy in the hope of attaining a maximal quality of life for their patients,’ the US medical researchers Dr Harry Ziel and Dr William Finkle said in 1976. Equally objectionable were the pharmaceutical advertisements of this era that promoted HRT ‘for the menopausal problems that bother him the most [our emphasis]‘.

Yet there are many middle-aged and older women wanting to have genital sex with partners who feel the same. If the way their vaginas feel prevents this, they should consider the use of substances including oestrogen, either as a cream, tablet or pessary applied directly to the vagina, as pills to be swallowed, or in some other form. The crucial difference is that they understand and accept the therapy, with all its pros and cons, and use it to meet their own needs rather than the needs of others.

If you are wondering whether the direct application of oestrogen to the vagina has identical effects to that of oestrogen by pill, patch or implant, the answer is a conditional yes. Oestrogen-containing vaginal creams have the disadvantage of being messy, but they do increase lubrication and vaginal tone, and they may improve libido and feelings of wellbeing. They also impinge minimally on other body tissues when used as directed, thus reducing the chances of unwanted effects.

Testosterone implants to increase energy and sexual appetite are an appropriate option for some women. These can be used on their own or in addition to oestrogen.

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Related Posts:

• INTERMEDIATE SYMPTOMS OF THE MENOPAUSE
• HRT QUESTION: WHEN SHOULD PREVENTION OF OSTEOPOROSIS START?
• HORMONES USED FOR OSTEOPOROSIS
• HRT: WHAT ARE PROGESTERONE AND PROGESTOGEN?